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Precautions and Warnings With Pegloticase

Let your healthcare provider know if you have any medical issues, such as heart problems or high blood pressure, before receiving pegloticase. Precautions and warnings with this drug also apply to people who have certain allergies and women who are pregnant or nursing. Also, some people should avoid this prescription medication, including those who have glucose-6-phosphate dehydrogenase (G6PD) deficiency.

What Should I Tell My Healthcare Provider Before Receiving Pegloticase?

You should talk with your healthcare provider prior to receiving pegloticase (Krystexxa®) if you have:
 
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.
 

Specific Precautions and Warnings With Pegloticase

Some warnings and precautions to be aware of prior to receiving this drug include the following:
 
  • Pegloticase can cause dangerous allergic reactions. Less serious (but still quite bothersome) "infusion reactions" may also occur. Signs of allergic reactions or infusion reactions might include:
     
    • An unexplained rash
    • Itching
    • Hives
    • Redness of the face
    • Swelling of the mouth or throat
    • Wheezing
    • Difficulty breathing
    • Low blood pressure
    • Chest pain.
Let your healthcare know right away if you think you might be experiencing an allergic reaction or infusion reaction. Such reactions can occur during or after any dose of pegloticase.
  • In order to prevent or reduce allergic reactions or infusion reactions, you should be given a corticosteroid and an antihistamine before each dose of pegloticase.
     
  • The risk of allergic reactions or infusion reactions is higher in people with uric acid levels that are more than 6 mg/dL. Your healthcare provider may decide to monitor your uric acid levels (using a simple blood test) and might recommend against using this medication, especially if you have two consecutively high levels in a row.
     
  • Pegloticase works to prevent gout attacks; it does not help treat attacks that are already occurring. In fact, it can temporarily worsen gout, especially at first. For these reasons, pegloticase is typically used along with other gout medications, especially for the first six months.
     
  • Pegloticase might possibly worsen congestive heart failure (CHF). If you have a history of heart problems, you may want to discuss this possibility with your healthcare provider.
     
  • Pegloticase is considered a pregnancy Category C medication. This means that it may not be safe to use this medication during pregnancy. Talk to your healthcare provider about the risks and benefits of using this drug during pregnancy (see Krystexxa and Pregnancy for more information).
     
  • It is not known if pegloticase passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, make sure to talk with your healthcare provider about using pegloticase (see Krystexxa and Breastfeeding).
     
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